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Association between low back movement control impairment test results and low back pain - Northern Finland birth
Peetu Robert Rytkönen1, Jani Takatalo2,3, Hannu Luomajoki4
1Research Unit of Health Sciences and Technology, University of Oulu, Oulu, Finland. peetu.r.rytkonen@student.oulu.fi.
Background:
Movement control impairment (MCI) tests of patients with chronic low back pain (LBP) have shown good validity. However, the association between MCI test results and LBP has not been evaluated in a population-based cohort.
Methods:
The participants of this cross-sectional study consisted of 1907 members of the Northern Finland Birth Cohort 1966. Their assessment included the MCI tests of sitting knee extension (SKE), prone knee bend (PKB), one leg stance (OLS), rocking backwards (RB) and waiter's bow (WB). The tests were classified as positive or negative. The SKE, PKB and OLS tests were performed on the left and right sides separately and then summed up to include both sides. Each MCI test evaluates at least one movement direction; flexion (SKE, RB, WB), extension (PKB), rotation (SKE, PKB, OLS), flexion-rotation (SKE, OLS) and extension-rotation (PKB, OLS). The participants' pain level was categorized as mild, moderate, or severe according to the frequency and perceived bothersomeness of LBP. The outcomes were LBP, sciatica and prolonged sciatica (duration over three months). Multinomial regression analysis was used to analyse the association between each MCI direction and the symptoms, and adjusted for body mass index, sex, socioeconomic status, psychological symptoms, physical activity, and smoking. The reference categories were mild symptoms and negative MCI test results of the respective direction.
Results:
Three positive left-side rotation MCI test results were associated with moderate (odds ratio [OR] 2.81; 95% confidence interval (CI) 1.22-6.50) and severe (2.98; 1.20-7.40) LBP. Two and three positive rotation tests (both sides) were also associated with severe LBP (2.31; 1.02-5.24 and 3.03; 1.27-7.24, respectively). Two positive left-side flexion-rotation test results were associated with moderate LBP (1.83; 1.01-3.29) and one positive flexion-rotation test result (both sides) with severe LBP (1.84; 1.08-3.10). One positive right-side flexion-rotation test result was negatively associated with moderate prolonged sciatica (0.28; 0.10-0.77).
Conclusions:
Positive rotational MCI test results were associated with moderate and severe LBP in this large-scale population-based cohort. The reason for the association between positive rotational test results and LBP, especially left-sided, requires further research.
